January 16, 2015 — A 76-year-old man with prostate cancer has become the first radiotherapy patient in the world whose treatment was planned using new RapidPlan knowledge-based software from Varian Medical Systems. Specialists at Royal Surrey County Hospital in Guildford, England, carried out the advanced intensity modulated radiotherapy (IMRT) treatment using RapidPlan to plan and guide the process.

"We planned the patient's treatment both conventionally and using RapidPlan and we were comfortable that the RapidPlan treatment plan produced better dose delivery and beam modulation," says Tom Jordan, head of radiotherapy physics. "With RapidPlan, the mean target dose achieved was slightly higher and the beam-shaping efficiency was greater, giving reduced dose to the critical normal tissues as compared to a conventional plan. It also greatly speeded up the planning process by automating the selection of planning parameters."

RapidPlan is a comprehensive tool within Varian's Eclipse treatment planning system that may be used to plan all types of IMRT, including image-guided radiotherapy (IGRT), RapidArc radiotherapy and stereotactic ablative radiotherapy (SABR). IMRT is a type of radiotherapy that focuses precisely on the tumor while minimizing exposure of surrounding healthy tissues. RapidPlan software allows radiotherapy physicists and clinicians to generate standard models to use as a baseline for developing new IMRT treatment plans for their patients.

Jordan explained that once a model had been created for a particular disease site by inputting a library of historical plans into the system, the RapidPlan system then typically suggests a better plan. "There is some work involved in inputting the data but once you have between 20 and 40 previous relevant cases in the system and you have optimized the planning priorities, it becomes a lot faster to produce plans for future treatments in RapidPlan," he said.

"When learning to plan complex cases, it can take practitioners a number of years to gain the necessary experience but with RapidPlan we are able to simplify the process by working from standard models. We anticipate it being very useful in advanced healthcare countries such as here in the United Kingdom but it can easily be envisaged that it could be very helpful in implementing advanced radiotherapy in developing countries where they may lack enough skilled practitioners to plan treatments," added Jordan.

The team at Royal Surrey County Hospital, which hopes ultimately to plan all treatments using RapidPlan, has worked together with researchers at the University of Surrey to submit this work for presentation at ESTRO, the foremost European conference on radiotherapy and oncology. Jordan and his team have so far also developed a case model using RapidPlan for treatments of cancer in the cervix.

Henry Ford Hospital's ViewRay MRIdian linear accelerator system allows real-time MRI-guided radiotherapy. Shown is the support staff for this system. In the center of the photo is Benjamin Movsas, M.D., chair of radiation oncology at Henry Ford Cancer Institute. Second from the right is Carri Glide-Hurst, Ph.D., director of translational research, radiation oncology.